Education, health and care (EHC) plans were introduced in England in 2014, as a replacement for statements of special educational needs. Unexpectedly, the number of children and young people in receipt of an EHC plan rose by 49% during the 5 years up to 2019. Whilst most of the increase has been due to the extension of the age range up to age 25, there has still been a notable rise of 20% in the 0-15-year range. This study explores the trends and variations in EHC plans and tribunals within English local authorities (LAs) for children and young people with special educational needs and disability (SEND) by interrogating the latest full set of data from 2013 to 2018. Two quintile groups (n = 30) are used for comparing LAs with high and low levels of EHC plans and LA case studies are also presented for further inspection of the data. Wide variations across LAs still exist for EHC plans (5.2% to 1.0%) and tribunal appeals (43 to 0 per 10,000). LAs with low EHC plans have more appealable decisions at tribunals and are financed at significantly lower levels than LAs with high EHC plans, largely due to an historic spend factor of 50% in the national funding formula. There are also clear differences between the English regions for both EHC plans and tribunals, with high increases for both in the South East. The implications of the findings are discussed within the framework of LA critical self-reviews, benchmarking, fiscal constraints and inclusion.